Individual
MRS. STACEY ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHS, CCC-SLP
Contact information
Practice address
5016 S CEDAR CREST AVE, INDEPENDENCE, MO 64055-6933
(312) 545-0383
Mailing address
5016 S CEDAR CREST AVE, INDEPENDENCE, MO 64055-6933
(312) 545-0383
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
146.011918
IL
235Z00000X
Speech-Language Pathologist
Primary
2007016503
MO
Other
Enumeration date
06/14/2007
Last updated
07/02/2024
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